Children’s surgery waiting lists hits record high as NHS fails to tackle spiralling backlog

Exclusive: ‘The pace of recovery of paediatric services has not kept up with the level of adult elective care,’ NHS admits in leaked documents

Rebecca Thomas
Health Correspondent
Thursday 11 May 2023 16:57 BST
Children’s surgery waiting lists topped 403,000 for the first time on Thursday
Children’s surgery waiting lists topped 403,000 for the first time on Thursday (Getty)

Hospitals are failing to tackle spiralling children's surgery waiting lists as the backlog hits more than 400,000 for the first time.

Leaked documents show children’s waiting lists for both inpatient and outpatient care are “increasing at double the rate of adults” and, despite efforts, services have failed to catch up after they were paused during the pandemic.

NHS leaders have repeatedly raised concerns about the backlog amid warnings that services for young people have been “deprioritised” to cut adult lists.

One NHS leader warned that the long waits would be likely to affect some children’s “ability to lead full and active lives” and worsen existing inequalities between adult and children’s care.

Leaked documents seen by The Independent show:

  • The rate of children’s surgery is 15 per cent lower compared to adults in the worst performing area – the east of England.
  • Between September 2021 to March 2022, the number of children waiting more than 78 weeks for hospital care increased by 43 per cent compared to 21 per cent for adults.
  • 70 per cent more adults were seen for scans and diagnostic tests needed for surgery in 2022 compared to children.

The news comes as the NHS’ waiting list for children reached 403,000 for the first time on Thursday and as the overall waiting list figure in England hit a record 7.3 million. However, the figures will likely hide the true scale of the waits as it does not include all specialities and community services where there was a waiting list of 227,000 for children in March.

Has your child been impacted by a long wait for care? email

Shadow health secretary Wes Streeting said the figures showed “children are paying the price for 13 years of Conservative failure to give the NHS the staff it needs”.

In documents seen by The Independent, NHS leaders have been told to speed up the number of surgeries being done for children to the same level that were being carried out in 2019-20 by the next financial quarter.

Experts told The Independent that tackling the backlog was difficult because some surgeons had lost confidence and were out of practice after they were pulled from children's surgery to work on Covid wards.

Ronny Cheung, officer for health services at the Royal College of Paediatrics and Child Health, said the leaked documents highlighted "two key dangers”.

He said children’s services were recovering slowly with wide variations across the country and while adult waiting lists have shrunk, children’s lists have risen with some patients waiting more than a year for treatment.

He added: “It is unacceptable that children’s services seem to have been deprioritised. Paediatricians are working extremely hard to see as many children and young people as possible to address the pandemic backlog and growing need, but they cannot address this challenge without support. Fundamentally we need urgent action and investment from the government to help close these gaps between adult and children’s services.”

It comes as paediatric staff within major specialist hospitals, such as Great Ormond Street, warned services are “running on a knife edge” and described having to “beg nurses daily” to cover shifts because staff are overworked.

The Independent understands that NHS leaders are set to mount a campaign to urge hospitals to tackle the issue, although no additional funding has been set out to support this.

In one NHS England briefing seen by The Independent, healthcare leaders were told: “Long waits are likely to impact their [children’s] ability to access education and lead full and active lives, exacerbating existing inequalities. Local systems and providers have made huge efforts to restore paediatric elective services, however, activity largely remains below pre-pandemic levels.”

New figures show the NHS is failing to hit waiting list targets (PA)
New figures show the NHS is failing to hit waiting list targets (PA) (PA Wire)

It said national internal data shows that “the pace of recovery of paediatric services has not kept up with the level of adult elective care”.

In response to the problem, NHS England has set up teams to ensure the recovery of paediatric care “keeps pace with or exceeds” the pace of recovery of adult care, the documents show.

One NHS regional leader said: “There is a major underlying concern that paediatric recovery is coming secondary to adults. There are operational reasons behind that. Most of the time, the numbers are a lot smaller, depending on the organisation. A lot of organisations don’t split out adults and paediatrics on numbers and stuff. So there is a real concern they get left behind.

“Equally, and probably more concerning than that, is there are several organisations that haven’t really restarted paediatric care. They stopped over Covid and then have never really restarted. So there is a real concern over the lack of service provision for paediatrics.”

“There’s a real concern that a lot of these organisations have just completely stopped and that will mean a real shortfall of paediatric services nationally.”

In one letter sent in November by a specialist group of surgeons to hospitals in the West Midlands, trust leaders were warned over the “fragility” and “lack of prioritisation” of children’s surgery with some subspecialties “having broken down completely – both in terms of elective and emergency care”.

The letter added: “This is often linked to maintenance of paediatric competent surgeon workforce.”

Mr Streeting added: “What kind of start in life are these children getting if they’re spending as long as 18 months waiting for healthcare?

“Labour will abolish the non-dom tax status to train 7,500 more doctors and 10,000 more nurses a year, so children can be treated on time again. Every child matters, so we will also train 5,000 more health visitors to give every child a healthy start to life.”

A spokesperson for NHS England said trusts faced extraordinary challenges, including Covid and industrial action alongside “huge” demand, but have made good progress on reducing 18-month waits, which included “many” children.

The NHS said it was investing in new surgical capacity and staffing to find innovative ways to tackle the paediatric backlog.

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